<div class="row">
<div class="col-75"><div class="container">
<form action="/action_page.php">
<div class="row">
<div class="col-50">
<h3>Billing Address</h3>
<label for="fname"><i class="fa fa-user"></i> Full Name</label>
<input type="text" id="fname" name="firstname" placeholder="John M. Doe">
<label for="email"><i class="fa fa-envelope"></i> Email</label>
<input type="text" id="email" name="email" placeholder="john@example.com">
<label for="adr"><i class="fa fa-address-card-o"></i> Address</label>
<input type="text" id="adr" name="address" placeholder="542 W. 15th Street">
<label for="city"><i class="fa fa-institution"></i> City</label>
<input type="text" id="city" name="city" placeholder="New York">
<div class="row">
<div class="col-50">
<label for="state">State</label>
<input type="text" id="state" name="state" placeholder="NY">
</div>
<div class="col-50">
<label for="zip">Zip</label>
<input type="text" id="zip" name="zip" placeholder="10001">
</div>
</div>
</div>
<div class="col-50">
<h3>Payment</h3>
<label for="fname">Accepted Cards</label>
<div class="icon-container">
<i class="fa fa-cc-visa" style="color:navy;"></i>
<i class="fa fa-cc-amex" style="color:blue;"></i>
<i class="fa fa-cc-mastercard" style="color:red;"></i>
<i class="fa fa-cc-discover" style="color:orange;"></i>
</div>
<label for="cname">Name on Card</label>
<input type="text" id="cname" name="cardname" placeholder="John More Doe">
<label for="ccnum">Credit card number</label>
<input type="text" id="ccnum" name="cardnumber" placeholder="1111-2222-3333-4444">
<label for="expmonth">Exp Month</label>
<input type="text" id="expmonth" name="expmonth" placeholder="September">
<div class="row">
<div class="col-50">
<label for="expyear">Exp Year</label>
<input type="text" id="expyear" name="expyear" placeholder="2018">
</div>
<div class="col-50">
<label for="cvv">CVV</label>
<input type="text" id="cvv" name="cvv" placeholder="352">
</div>
</div>
</div>
</div>
<label>
<input type="checkbox" checked="checked" name="sameadr"> Shipping address same as billing
</label>
<input type="submit" value="Continue to checkout" class="btn">
</form>
</div>
</div>
<div class="col-25">
<div class="container">
<h4>Cart
<span class="price" style="color:black">
<i class="fa fa-shopping-cart"></i>
<b>4</b>
</span>
</h4>
<p><a href="#">Product 1</a> <span class="price">$15</span></p>
<p><a href="#">Product 2</a> <span class="price">$5</span></p>
<p><a href="#">Product 3</a> <span class="price">$8</span></p>
<p><a href="#">Product 4</a> <span class="price">$2</span></p>
<hr>
<p>Total <span class="price" style="color:black"><b>$30</b></span></p>
</div>
</div>
</div>
